Bioterrorism: Background and Significancefaculty.mtsac.edu/cbriggs/Micr-22 Bioterrorism...
Transcript of Bioterrorism: Background and Significancefaculty.mtsac.edu/cbriggs/Micr-22 Bioterrorism...
Bioterrorism:
Background and Significance
Materials from: • Minnesota Department of Health, • Dr. Brent L. Iverson and the Outreach Lecture Series of the
Environmental Science Institute of the University of Texas at Austin, and Rashid A. Chotani, M.D., MPH
• Lisa Astuto-Gribble, Sandia National Labs
Take-Home Lessons:1. Biological weapons are cheap to make and easy to conceal.
2. They have been of little military significance thus far, but of tremendous value from a propaganda perspective
3. Points 1. and 2. make biological weapons ideal for terrorism
4. American scientists are still playing “catch-up”, but have created several promising approaches to reduce the threat of biological weapons
An Abbreviated HistoryBiological Weapons have been contemplated since antiquity
"Replica catapult". Licensed under CC BY-SA 3.0 via Wikimedia Commons
Christopher, et al., JAMA, 1997, 278, 412-417
1763 - British commander Sir Jeffrey Amherst orders blankets used in smallpox clinic given to Native Americans as gifts
An Abbreviated History
Sir Jeffrey Amherst
WWI: Livestock and cavalry horses targeted in Europe using animal-specific diseases (ex: glanders, from Burkholderia malleri). This was apparently very successful.
An Abbreviated History
1st Lt. Lieutenant R.F. Okershauser making a Mallein test for glanders. All animals receive this treatment every 20 days for glanders. La Valdahon, Doubs, France. 01/28/1919
WWII: Japanese launched at least 11 attacks on Chinese cities using pathogens including anthrax, cholera, salmonella, and plague.
Christopher, et al., JAMA, 1997, 278, 412-417
An Abbreviated History
The main impact of biological weapons has been propaganda:China, the Soviet Union, and North Korea accused the US of using biological weapons in the Korean war.
Christopher, et al., JAMA, 1997, 278, 412-417
Leitenberg, M. Crit. Rev. Microb., 1998, 24, 169-194
An Abbreviated History
There are confirmed recent terrorist/criminal examples:
1984 in rural Oregon a religious cult infected 751 residents with food poisoning through Salmonella contamination at 10 restaurants in an attempt to win local elections.
Kolovic, et al., JAMA, 1997, 278, 396-398 Torok, et al., JAMA, 1997, 278, 389-395Christopher, et al., JAMA, 1997, 278, 412-417
Biological Weapons have been contemplated since antiquity
An Abbreviated History
oregonlive.com
oregonlive.com
Bhagwan Shree Rajneesh and Ma Anand Sheela, oregonlive.com
MN Patriots Council, Douglas County, 1991
There are confirmed recent terrorist/criminal examples:
Early 1990’s the Japanese Aum Shrinrikyo cult released Anthrax in Tokyo, but no known victims. Apparently, this was not “weaponized” correctly.
Kolovic, et al., JAMA, 1997, 278, 396-398 Torok, et al., JAMA, 1997, 278, 389-395 Christopher, et al., JAMA, 1997, 278, 412-417
Biological Weapons have been contemplated since antiquity
An Abbreviated History
There are confirmed recent terrorist/criminal examples:
1996 the pathogen that causes dysentery was introduced into pastries in the break room of the St. Paul’s Medical Center in Dallas, infecting 45.
Kolovic, et al., JAMA, 1997, 278, 396-398 Torok, et al., JAMA, 1997, 278, 389-395Christopher, et al., JAMA, 1997, 278, 412-417
Biological Weapons have been contemplated since antiquity
An Abbreviated History
September of 2001 Anthrax laden letters sent to several locations in US. 22 confirmed cases of anthrax were reported, 11 cases of inhalation anthrax, 5 deaths.
Inglesby, et al., JAMA, 2002, 287, 2236-2252
There are confirmed recent terrorist/criminal examples:
Biological Weapons have been contemplated since antiquity
An Abbreviated History
Review of 33 incidents from 1960 – 1999
(J.B. Tucker 1999. Emerging Infectious Diseases)
Efforts to control materials
Alternative motivations
Advantages of Biologics As Weapons
• May be easier, faster to produce and more cost-effective than other weapons
• Potential for dissemination over large geographic area• High morbidity and mortality• Creates panic • Person-to-person transmission possible (smallpox,
plague, and viral hemorrhagic fever)• Difficult to diagnose and/or treat
Ideal Characteristics for Potential Biological Terrorism Agent
• Inexpensive and easy to produce
• Can be aerosolized (1-10 µm)
• Survives sunlight, drying, heat
• Cause lethal or disabling disease
• Person-to-person transmission
• No effective treatment or prophylaxis
Biological Agents Ranking System
Public Health impact criteria based on:
• Morbidity and mortality
• Delivery potential
• Public perception (fear, civil disruption)
• Public health preparedness needs
Level A Bioterrorism Agents
• Anthrax (Bacillus anthracis)• Smallpox (Variola major)• Plague (Yersinia pestis)• Botulism toxin (Clostridium botulinum)• Tularemia (Francisella tularensis)• Viral hemorrhagic fevers (VHF)
Other Potential Bioterrorism Agents
• Brucellosis (Brucella species)• Glanders (Burkholderia mallei)• Q fever (Coxiella burnetii)• Cholera (Vibrio cholera)• Salmonella sp. and Shigella sp.• Venezuelan Equine Encephalitis (VEE)• Staphylococcal Enterotoxin B• Ricin (from castor beans)• T-2 Mycotoxins
(Note that this is not a complete listing)
Estimated Casualties From a Hypothetical Bioterrorism Release*
Agent
Rift Valley FeverTyphusBrucellosisPlagueQ FeverTularemiaAnthrax
Downwind Reach(km)
151010>20>20>20
Dead
1002,500
1506,500
504,500
24,000
Sick**
10,00030,00027,00027,00060,00060,00060,000
*50 kg by aircraft, 2 km line upwind of a city of 500,000** Includes deaths
Symptoms of Potential Bioterrorism Diseases - Challenges of Detection
Anthrax
Plague
Q fever
Tularemia
Smallpox
Agent
Mediastinitis
Pneumonia
Pleuritis, hepatitis
Pneumonia
Pustules
Clinical Effect
} Headache
Fever
Malaise
Cough
InitialSymptoms
Biological Terrorism?Epidemiologic Clues
• Tight cluster of cases• High infection rate• Unusual or localized geography• Unusual clinical presentation• Unusual time of year• Dead animals